Wire-Guided Lumpectomy

What is a wire-guided lumpectomy? • A lumpectomy, sometimes called a partial mastectomy, is the surgical removal of an area of breast tissue. This is as opposed to a total mastectomy, in which all the breast tissue would be removed.

• A wire localization is done by radiology to help your surgeon to locate the area of breast tissue that needs to be removed. o Before your surgery, on the same day, a radiologist will take pictures of your breast using the mammogram or ultrasound.

o When (s)he locates the area in question, (s)he will use lidocaine to numb part of your breast.

o (S)he then will insert a very thin wire into the breast to the target area of breast tissue to be removed. This wire will stick out of your skin, but you will have a bandage placed over it so you can’t see it or move it.

o During surgery, your surgeon follows this wire as a guide to the target area. The wire will be removed with the area of breast tissue.

• After surgery, the removed tissue (“the specimen”) is sent to pathology to be looked at under the microscope by a pathologist. If your surgery is to remove cancer, one of the things the pathologist will report is the margin status. This refers to the edges of the specimen. If cancer cells are at or close to a margin, your surgeon may recommend re-excision.

o This means you would come back for another day surgery on a different day, and your surgeon would take a little more tissue from that margin.

o Most of the time, if you need a re-excision, you will not need another wire localization.

Frequently Asked Questions

Q: Will a lumpectomy change the shape or size of my breast? A: Maybe. The answer depends on how much tissue your surgeon needs to remove, where the target area is, and the original size and shape of your breast.

Q: Will I have a scar? A: Most women have a small, subtle scar at the site of lumpectomy. If you tend to develop dark scars, you are more likely to have a visible scar.

Q: How long does the lumpectomy procedure take? A: A lumpectomy alone is usually under an hour. You can plan to be at the hospital for at least half the day.

Q: What kind of anesthesia is used? A: General anesthesia may be used, but you may have the option to have a lighter form of sedation. You will have the opportunity to discuss anesthesia with a pre-op nurse, and then again on the day of surgery with your anesthesiologist.

Q: When will I know my margin status? A: The final pathology results from your surgery will take 1-2 weeks.